A historical perspective of the healthcare structure, delivery system, policy, and politics provides a framework through which stakeholders can analyze values and trends in healthcare. Over the years, owing to changing population health needs, healthcare in the US has evolved from a simple structure focused on the treating of illnesses and revolving around doctors to a complex, technological, and scientific system encompassing specialized healthcare personnel and putting more emphasis on patients. Simple healthcare policies emanated well structure policies covering vast areas such as healthcare insurance, health promotion, and healthcare workforce issues. As a result of technological advancements, the healthcare delivery system has also significantly developed to incorporate complex systems such as accountable care organizations and the delivery of healthcare through telehealth systems. The changes have made it easier and more efficient to deliver healthcare. The changing healthcare needs and technological advancements have inspired a transformation of the US healthcare system, structure, and policy, resulting in better delivery of care and improved population health.
Over the years, there has been a shift in the population’s healthcare needs. In the 1800 and 1900s, the US was characterized by a much younger and smaller population. The population at the time did not present with complex healthcare issues and illnesses. Acute injuries presented the most common complaints. Most illnesses, with the exceptions of pandemics such as the Spanish flu, affected individuals rather than communities or large groups of people (Shi & Singh, 2022). As a result, the healthcare system consisted of physicians as the primary providers of care. As the population grew, more complex illnesses developed. One of the current challenges in the healthcare system is an aging population at risk for chronic lifestyle illnesses such as type II diabetes and cardiovascular illnesses (Dieleman et al., 2020). As new and more challenging illnesses developed, the healthcare system also evolved to meet the needs of the population. More physicians specialized in pulmonologists and gerontologists, among others, to respond to the need. In addition, professionals such as nurses undertook a more refined and defined role in the delivery of care. The development of advanced practice nurses is a testament to the evolution of healthcare delivery.
The rising population, healthcare needs, and cost of healthcare also necessitated a change in healthcare policy, especially healthcare insurance. From a simple healthcare management organization and a largely privatized system, healthcare insurance has evolved into a hybrid system that includes public and private coverage. The Affordable Care Act, which was enacted in 2010, represents one of the hallmark changes in healthcare insurance that enabled many disadvantaged individuals and communities to access healthcare coverage (Dieleman et al., 2020). Healthcare policies have been developed to protect consumers and ensure that citizens get high-quality healthcare services.
Technological advancements have also played an imperative role in healthcare delivery and structure. New diagnostic equipment has helped improve the quality of diagnoses, allowing clinicians to treat conditions that were untreatable in the past (Shi & Singh, 2022). The computer and the internet have, especially, been integral to the changing healthcare system in the US. The computer has allowed the transition to electronic health records from the paper system (Shi & Singh, 2022). In addition, both the computer and the internet have allowed for the remote delivery of healthcare through telehealth.
The healthcare structure and system in the US have significantly changed. Rapid technological innovations and new population health demands have inspired these changes. With the increase in population and the emergence of health challenges such as cardiovascular illnesses, the healthcare system and policies have become more complex to meet these demands. The adoption of technology in healthcare has allowed for a more seamless delivery system and better-quality healthcare services.
References
Dieleman, J. L., Cao, J., Chapin, A., Chen, C., Li, Z., Liu, A., … & Murray, C. J. (2020). US health care spending by payer and health condition, 1996-2016. Jama, 323(9), 863-884.
Shi, L., & Singh, D. A. (2022). Essentials of the US health care system. Jones & Bartlett Learning.
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